Hypertension and obesity

• Published in: Journal of human hypertension Vol. 16; no. S1; pp. 18 - 22
• Main Author: DIAZ, M. E
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Basingstoke Nature Publishing 01.03.2002; Nature Publishing Group
• Subjects: Adult; Aged; Aged, 80 and over; Apnea; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood pressure; Body Mass Index; Body weight; Carbohydrate metabolism; Cardiology. Vascular system; Cardiovascular diseases; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Conformation; Female; Heart; Humans; Hypertension; Hypertension - epidemiology; Hypertension - etiology; Hypertension - physiopathology; Hypertrophy; Hyperuricemia; Lipid metabolism; Male; Medical sciences; Middle Aged; Obesity; Obesity - complications; Obesity - epidemiology; Obesity - physiopathology; Population studies; Prevalence; Risk Factors; Sleep; Sleep apnea; Sleep disorders; Urban Population; Uruguay - epidemiology; Ventricle; Uruguay; Human; Hypertension; Obesity; Pathogenesis; Nutrition disorder; Risk factor; Cardiovascular disease; Nutritional status
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/sj.jhh.1001335

Obesity, as defined by bodily weight (body weight) and by bodily conformation-derived variables, accompanies hypertension in many patients. Both conditions are independent cardiovascular risk factors. In a formal survey carried out in the adult general population of Uruguay (LATIR Study, 575 adult and elderly subjects of whom 41.6% were males), we found the prevalence of hypertension to be 28.5% (95% CI: 24.9-32.4%) and that 74.4% of hypertensive individuals had a body mass index (BMI) higher than 25 kg/m(2) (95% CI: 67.0-80.8%). This association between obesity and hypertension forms part of a broader relationship between body weight and blood pressure (BP). In the general population, BP bears a positive linear correlation with BMI and waist-to-hip ratio over the continuous ranges of normal and unfavourable values of these three variables (r = 0.42, P < 0.001 for the correlation between BMI and mean BP, LATIR Study). Patients who present hypertension and obesity usually present other unfavourable conditions for cardiovascular prognosis, including changes in carbohydrate and lipid metabolism, hyperuricaemia, left ventricular hypertrophy, and/or the obstructive sleep apnoea syndrome. On average, hypertension is salt-sensitive in obese patients, and plasma volume and cardiac index are increased. Adequate control of body weight results in substantial reductions in total blood volume, cardiac output, BP and left ventricular mass, and in an amelioration or the disappearance of sleep apnoea. Adequate sodium intake restriction must form part of any diet prescribed to obese hypertensive patients. Various drug classes may be used to treat hypertension efficaciously in patients who also present obesity.